ZeroOCD: Learn to Overcome Contamination OCD With Your Smartphone

NCT ID: NCT07194473

Last Updated: 2025-09-26

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 189 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-09-21
• Study Completion Date: 2027-05-31

Brief Summary

This study is a three-arm randomized controlled trial designed to evaluate the efficacy of a smartphone-based augmented reality (AR) cognitive behavioral therapy (CBT) app, called ZeroOCD, for individuals with elevated contamination-related obsessive-compulsive disorder (OCD) symptoms. The AR-CBT app will be compared to both an active control condition (manualized CBT via videoconferencing) and a waitlist control group.

Detailed Description

Obsessive-compulsive disorder (OCD) is a prevalent and disabling condition, with contamination fears being one of its most common presentations. While Cognitive-Behavioral Therapy (CBT) with Exposure and Response Prevention (ERP) is a first-line treatment, many individuals face barriers to accessing it, such as cost, stigma, and availability of therapists. This multicenter trial, conducted in the Netherlands, Belgium, Sweden, and Switzerland, will recruit a total of 189 individuals experiencing contamination-related obsessive-compulsive symptoms. Participants will be randomized to one of three study conditions (allocation ratio 2:2:1): The first group (n = 75) receives access to ZeroOCD, an augmented reality (AR) based smartphone application, which provides CBT and ERP for contamination fears, along with three therapist support sessions via videoconferencing. The second group (n = 75) receives weekly CBT for OCD via videoconferencing (nine sessions in total). The third group is a waitlist control group (n = 39), who will receive access to the smartphone application with minimal therapist support on request after 10 weeks in the study. The study aims to evaluate the effectiveness of the ZeroOCD intervention compared to both a waitlist control and videoconferencing CBT, and to assess cost-effectiveness and usability. Assessments are conducted at baseline, 10 weeks post-randomization, and at 6-month follow-up for the intervention groups. Participants in the waitlist group complete assessments at baseline, 10 weeks post-randomization, and receive access to the ZeroOCD intervention 10 weeks after randomization. Further, the waitlist group will complete an assessment 20 weeks post-randomization. The study is a multicenter trial involving participants in Switzerland, the Netherlands, Belgium, and Sweden.

Conditions

Obsessive Compulsive Disorder (OCD)

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

ZeroOCD AR-CBT App + 3 therapist support sessions

Participants will use the ZeroOCD smartphone application, which delivers 9 modules of augmented reality exposure therapy and cognitive behavioral therapy principles. This group will also receive 3 videoconferencing sessions with a therapist at the beginning, middle, and end of the 10-week treatment period.

Group Type: EXPERIMENTAL

ZeroOCD

Intervention Type: BEHAVIORAL

The ZeroOCD app contains the following components:

psychoeducation, detecting obsessive thoughts, coping with obsessions, goal setting, fear curve explanation, exposure with AR, re-exposure with AR, exposure hierarchy, exposure in real-life, re-exposure in real life and relapse prevention

Videoconferencing CBT

Participants will receive 9 weekly sessions of manualized Cognitive Behavioral Therapy with Exposure and Response Prevention (ERP) delivered via videoconferencing by trained therapists.

Group Type: ACTIVE_COMPARATOR

Videoconferencing CBT

Intervention Type: BEHAVIORAL

Videoconferencing CBT contains the following chapters:

psychoeducation, detecting obsessive thoughts, coping with obsessions, goal setting, fear curve explanation, exposure hierarchy, exposure in real-life, re-exposure in real life and relapse prevention

Waitlist control group

Participants in this group will receive access to the ZeroOCD app with therapist support on request after a 10-week waiting period.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

ZeroOCD

The ZeroOCD app contains the following components:

psychoeducation, detecting obsessive thoughts, coping with obsessions, goal setting, fear curve explanation, exposure with AR, re-exposure with AR, exposure hierarchy, exposure in real-life, re-exposure in real life and relapse prevention

Intervention Type: BEHAVIORAL

Videoconferencing CBT

Videoconferencing CBT contains the following chapters:

psychoeducation, detecting obsessive thoughts, coping with obsessions, goal setting, fear curve explanation, exposure hierarchy, exposure in real-life, re-exposure in real life and relapse prevention

Intervention Type: BEHAVIORAL

Other Intervention Names

ZeroOCD AR-CBT App + 3 therapist support sessions

Eligibility Criteria

Inclusion Criteria

• • OCD symptoms, mean score > 7 on the Yale Brown Obsessive Compulsive Scale (Y-BOCS)

• Fear of contamination OCD symptoms, mean score > 6 on the Padua Inventory contamination fear subscale (PI)
• Having access to a compatible smartphone
• Having an internet connection
• Proficiency in one of the countries' languages (i.e., Dutch/ Flemish, German, or Swedish)
• Willing to participate in the research study and provide informed consent

Exclusion Criteria

• • Having been diagnosed with bipolar or psychotic disorder (self-report)

• Severe depressive symptoms (Patient Health Questionnaire, PHQ-9, score > 20)
• Reporting suicidality (PHQ-9, item 9 > 2 points at screening)
• Fear of contamination due to disorder other than OCD (clinical judgment based on results from the Yale Brown Obsessive Compulsive Scale, Y-BOCS, Generalized Anxiety Disorder-7 items, GAD-7, Short Health Anxiety Inventory, SHAI)
• Parallel psychological treatment
• Non-stable dosage of psychoactive medication during the last three months or planned changes during the study period.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 64 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of Bern

OTHER

Sponsor Role: collaborator

Stockholm University

OTHER

Sponsor Role: collaborator

Thomas More University of Applied Sciences

OTHER

Sponsor Role: collaborator

VU University of Amsterdam

OTHER

Sponsor Role: lead

Responsible Party

Tara Donker

Associate Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Thomas More Mechelen

Mechelen, , Belgium

Vrije Universiteit Amsterdam

Amsterdam, North Holland, Netherlands

Stockholm University

Stockholm, , Sweden

UBERN

Bern, , Switzerland

Countries

Belgium; Netherlands; Sweden; Switzerland

Central Contacts

Tar Donker, PhD

Role: CONTACT

t.donker@vu.nl

0205988265

Facility Contacts

Tom van Daele, PhD

Role: primary

tom.vandaele@thomasmore.be

32 2 218 16 20

Per Carlbring, PhD

Role: primary

per.carlbring@psychology.su.se

08-16 39 20 of 070-666 7 666

Thomas Berger, PhD

Role: primary

thomas.berger@unibe.ch

+41 31684 34 07

Other Identifiers

ZeroOCD/FP-1478

Identifier Type: -

Identifier Source: org_study_id